Raw is risky: 17 sick with Campylobacter from raw milk in Colorado, 2016

In August 2016, a local public health agency (LPHA) notified the Colorado Department of Public Health and Environment (CDPHE) of two culture-confirmed cases of Campylobacter infection among persons who consumed raw (unpasteurized) milk from the same herdshare dairy.

In Colorado, the sale of raw milk is illegal; however, herdshare programs, in which a member can purchase a share of a herd of cows or goats, are legal and are not regulated by state or local authorities. In coordination with LPHAs, CDPHE conducted an outbreak investigation that identified 12 confirmed and five probable cases of Campylobacter jejuni infection. Pulsed-field gel electrophoresis (PFGE) patterns for the 10 cases with available isolates were identical using the enzyme Sma. In addition, two milk samples (one from the dairy and one obtained from an ill shareholder) also tested positive for the outbreak strain. Five C. jejuni isolates sent to CDC for antimicrobial susceptibility testing were resistant to ciprofloxacin, tetracycline, and nalidixic acid (1).

Although shareholders were notified of the outbreak and cautioned against drinking the milk on multiple occasions, milk distribution was not discontinued. Although its distribution is legal through herdshare programs, drinking raw milk is inherently risky (2). The role of public health in implementing control measures associated with a product that is known to be unsafe remains undefined.

Investigation and Results

On August 23, 2016, El Paso County Public Health notified CDPHE of two culture-confirmed cases of C. jejuni infection; campylobacteriosis is a reportable disease in Colorado. Both patients reported drinking unpasteurized milk from the same herdshare dairy in Pueblo County. Since 2005, obtaining raw milk by joining a herdshare program has been legal for Colorado residents, but selling raw milk is illegal. By purchasing a share of a herd (cows or goats), shareholders are entitled to a portion of the raw milk.

Because the prevalence of consuming unpasteurized milk is low (2.4% in Colorado, 2006–2007 FoodNet Population Survey; 3.1%, 2009 Colorado Behavioral Risk Factor Surveillance System), two cases of enteric illness with a common exposure to raw milk are unlikely to occur by chance (3,4). In this outbreak, a confirmed case was defined as diarrheal illness with onset on or after August 1, 2016, in a person with known consumption of unpasteurized milk from the same herdshare dairy and culture-confirmed C. jejuni infection. A probable case was defined as diarrhea onset on or after August 1, lasting 1 or more days, in a person with either known consumption of milk from the same herdshare dairy or with an epidemiologic link to a confirmed case.

Cases were identified through routine passive reporting with follow-up interviews, a Health Alert Network broadcast to area providers, and attempts to contact all shareholders. A public health order was issued to obtain a list of shareholders with their contact information after it was not provided by the dairy within 5 days of the initial request. CDPHE attempted to contact shareholders to inform them about the outbreak and assess possible illness. Up to three calls were made to each shareholder household. Epidemiologists contacted laboratories to request that isolates from potential outbreak-associated cases be forwarded to the state public health laboratory.

Among 91 (53%) of 171 shareholder households that responded to requests for follow-up interviews, representing 207 persons in five or more Colorado counties, 12 confirmed and five probable cases were identified (Figure). Among confirmed cases, patients ranged in age from 12 to 68 years (median = 58 years); nine were male. Duration of illness ranged from 3 to >10 days. One hospitalization occurred; there were no deaths. In addition to diarrhea, among the 12 confirmed cases, the majority of patients also experienced fever (10), abdominal pain or cramps (eight), headache (eight), and myalgia (seven); vomiting and bloody diarrhea were reported less frequently (in five and four persons, respectively).

Four milk samples were tested for C. jejuni; pathogen identification and PFGE were performed on available isolates from persons epidemiologically linked to the outbreak. C. jejuni with one of two outbreak PFGE patterns (PulseNet DBRS16.0008 using the enzyme Sma and PulseNet DBRK02.1272 or DBRK02.0028 using the enzyme Kpn) was confirmed in 10 isolates that were available at the public health laboratory and two of the four raw milk samples. The National Antimicrobial Resistance Monitoring System performed antimicrobial susceptibility tests on five representative isolates; all were resistant to ciprofloxacin, tetracycline, and nalidixic acid (1).

Public health responses to this outbreak consisted of notifying shareholders about the outbreak on three occasions and requiring the dairy to provide additional written notification about the outbreak at milk distribution points. A press release was issued by two LPHAs in response to detecting at least one infection in a person who was not a shareholder but was given milk by shareholders. In addition, a number of shareholders reported sharing milk with nonshareholders who might have been unaware of the outbreak. Although milk sample results were positive for C. jejuni, CDPHE did not close the dairy or stop distribution of its milk because without pasteurization CDPHE could not create standards for safely reopening the dairy (5). Shareholders were, however, urged to discard raw milk distributed since August 1 and were reminded that Colorado statute prohibits redistribution of raw milk.

Discussion

Raw milk from a herdshare dairy was the source of this outbreak of C. jejuni infections, and the investigation highlighted the difficulties inherent in addressing an outbreak related to unpasteurized milk from a herdshare dairy. During three previous herdshare-associated outbreaks in Colorado, public health authorities temporarily took action to stop milk distribution until a series of negative tests were obtained from the milk (Alicia Cronquist, CDPHE, personal communication, December 2017). However, because CDPHE could not ensure that unpasteurized milk would be safe in the future, the decision was made not to close the dairy during this outbreak. In addition, CDPHE’s Division of Environmental Health and Sustainability chose not to make formal recommendations on the dairy’s processes because no protocol improvements short of pasteurization could ensure the product’s safety, even with improved sanitation (5).

All tested isolates’ resistance to three antibiotics was concerning, particularly as fluoroquinolones are frequently used to treat Campylobacter infections in those cases where treatment is indicated. Treatment of antibiotic-resistant Campylobacter infections might be more difficult, of longer duration, and possibly lead to more severe illness than treatment of nonresistant Campylobacter infections (6–8). In 2015, approximately 25.3% of U.S. C. jejuni isolates were resistant to ciprofloxacin, an increase from 21.6% a decade earlier (1).

In collaboration with LPHAs, CDPHE is creating guidelines to address future outbreaks related to raw milk from herdshares. As more states legalize the sale or other distribution of unpasteurized milk, the number of associated outbreaks will likely increase (9,10). The role of public health in responding to raw milk–related outbreaks should be further defined. State-level guidelines might assist with this process.

 

Corresponding author: Alexis Burakoff, aburakoff@cdc.gov, 303-692-2745.

1Epidemic Intelligence Service, Division of Scientific Education and Professional Development, CDC; 2Colorado Department of Public Health and Environment, Denver, Colorado; 3Pueblo City-County Health Department, Pueblo, Colorado; 4El Paso County Public Health, Colorado Springs, Colorado; 5Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

References

CDC. National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS): human isolates surveillance report for 2015 (final report). Atlanta, Georgia: US Department of Health and Human Services, CDC; 2018.

CDC. Food safety: raw milk. Atlanta, GA: US Department of Health and Human Services, CDC; 2016. https://www.cdc.gov/foodsafety/rawmilk/raw-milk-index.html

CDC. Foodborne diseases active surveillance network (FoodNet) population survey atlas of exposures, 2006–2007. Atlanta, GA: US Department of Health and Human Services, CDC; 2011. https://www.cdc.gov/foodnet/PDFs/FNExpAtl03022011.pdf

Colorado Department of Public Health and Environment. Colorado Behavioral Risk Factor Surveillance System, 2009. [Data on raw milk]. Denver, CO: Colorado Department of Public Health and Environment; 2009. http://www.chd.dphe.state.co.us/Resources/brfss/BRFSS2009results_raw%20milk.pdf

Longenberger AH, Palumbo AJ, Chu AK, Moll ME, Weltman A, Ostroff SM. Campylobacter jejuni infections associated with unpasteurized milk—multiple states, 2012. Clin Infect Dis 2013;57:263–6. CrossRef PubMed

Evans MR, Northey G, Sarvotham TS, Rigby CJ, Hopkins AL, Thomas DR. Short-term and medium-term clinical outcomes of quinolone-resistant Campylobacter infection. Clin Infect Dis 2009;48:1500–6. CrossRef PubMed

Helms M, Simonsen J, Olsen KE, Mølbak K. Adverse health events associated with antimicrobial drug resistance in Campylobacter species: a registry-based cohort study. J Infect Dis 2005;191:1050–5. CrossRef PubMed

Nelson JM, Smith KE, Vugia DJ, et al. Prolonged diarrhea due to ciprofloxacin-resistant Campylobacter infection. J Infect Dis 2004;190:1150–7. CrossRef PubMed

Langer AJ, Ayers T, Grass J, Lynch M, Angulo FJ, Mahon BE. Nonpasteurized dairy products, disease outbreaks, and state laws—United States, 1993–2006. Emerg Infect Dis 2012;18:385–91. CrossRef PubMed

Mungai EA, Behravesh CB, Gould LH. Increased outbreaks associated with nonpasteurized milk, United States, 2007–2012. Emerg Infect Dis 2015;21:119–22. CrossRef PubMed

Outbreak of Fluoroquinolone-Resistant Campylobacter jejuni Infections Associated with Raw Milk Consumption from a Herdshare Dairy — Colorado, 2016

Morbidity and Mortality Weekly Report; February 9, 2018; 67(5);146–148

Alexis Burakoff, MD; Kerri Brown, MSPH; Joyce Knutsen; Christina Hopewell; Shannon Rowe, MPH; Christy Bennett; Alicia Cronquist, MPH

https://www.cdc.gov/mmwr/volumes/67/wr/mm6705a2.htm

Concerns raised about young people’s poor food safety knowledge as the academic year begins, Australian version

This is not surprising and with the amount of conflicting food safety information disseminated on the web, T.V., what are we to expect? It would be interesting to find out how many educational institutions teach food safety at school. There appears to be a significant push towards eating healthier which is great but is food safety discussed? When I moved out from my parents place, the last thing on my mind was food safety; as long as I had something to eat I was happy and looking back I took risks. I had the privilege of attending some prestigious schools during my youth, yet food safety was never discussed.
The Food Safety Information Council along with their member Cater Care are developing a poster highlighting food safety tips for young adults. I am not confident this will change anything, although I commend them for their efforts. Need to be more compelling and find innovative ways to grasp the attention of a young adult, a poster won’t do.

Scimex reports:

There are peaks of Campylobacter and Salmonella food poisoning cases among those aged between 20 and 25 years old, which is the age that many young people leave home for the first time. Food Safety Information Council consumer research shows young people are likely to have poorer knowledge of food safety basics such as washing hands, correct cooking temperatures, riskier foods and fridge safety. This is of particular concern as one of the part time jobs that young people are likely to take is working as a food handler.
Organisation/s: Food Safety Information Council
Media Release
From: Food Safety Information Council
As the academic year begins, the Food Safety Information Council, together with their member Cater Care, have launched a food safety tips poster for young people leaving home to start university and college.
Council Chair, Rachelle Williams, said that young people are at risk of getting food poisoning.
‘While the highest recorded rates of Campylobacter and Salmonella cases are among small children under 5 years old there is also a peak for those aged between 20 and 25 years old which is the age group that many young people leave home for the first time.
‘Our consumer research shows young people are likely to have poorer knowledge of food safety basics such as washing hands, correct cooking temperatures, riskier foods and fridge safety. This is of particular concern as one of the part time jobs that young people are likely to take is working as a food handler.
‘Students also tend to live in shared accommodation where the hygiene of the communal kitchen and fridge is easily neglected. There are an estimated 4.1 million cases of food poisoning in Australia each year and a case of gastro can seriously ruin the fun of those first few months away from home.
‘By following these five simple tips, you can help ensure that you, and people you cook for, are safe from food poisoning:
CLEAN – wash hands with soap and running water before handling food, wash the dishes regularly and keep the kitchen clean
CHILL – keep the fridge at 5°C or below and clean it out regularly. Bring your takeaway straight home and refrigerate any leftovers within 2 hours and use or freeze them within 3 days
COOK – cook poultry or minced products to 75°C in the centre, be aware of the risk of raw or minimally cooked egg dishes.
SEPARATE – prevent cross contamination especially between raw meat or poultry and other foods that won’t be cooked like salads
DON’T COOK FOR OTHERS IF YOU HAVE GASTRO – you could make them sick too so ask someone else to cook or get a takeaway.
‘The Food Safety Information Council would like to thanks our member Cater Care for developing this poster which can be downloaded here, ’ Ms Williams concluded.

 

113 sick with Campylobacter from Petland puppies

The U.S. Centers for Disease Control, several states, and the U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (USDA-APHIS) investigated a multistate outbreak of multidrug-resistant Campylobacter infections. Epidemiologic and laboratory evidence indicated that contact with puppies sold through Petland stores were a likely source of this outbreak. This outbreak investigation is over. Illnesses could continue to occur because people may be unaware of the risk of Campylobacter infections from puppies and dogs.

Cute puppies

A total of 113 people with laboratory-confirmed infections or symptoms consistent with Campylobacter infection were linked to this outbreak. Illnesses were reported from 17 states. Illnesses started on dates ranging from January 12, 2016 to January 7, 2018. Ill people ranged in age from less than 1 year to 86, with a median age of 27. Sixty-three percent of ill people were female. Of 103 people with available information, 23 (22%) were hospitalized. No deaths were reported. Whole genome sequencing (WGS) showed that isolates from people infected with Campylobacter were closely related genetically. This close genetic relationship means that people in this outbreak were more likely to share a common source of infection.

Campylobacter bacteria isolated from clinical samples from people sickened in this outbreak were resistant to commonly recommended, first-line antibiotics. This means it may be difficult to treat these infections with the antibiotics usually prescribed for Campylobacter infections. Antibiotic resistance may be associated with increased risk of hospitalization, development of a bloodstream infection, or treatment failure in patients. Using WGS, we identified multiple antimicrobial resistance genes and mutations in most isolates from 38 ill people and 10 puppies in this outbreak. This finding matched results from standard antibiotic susceptibility testing methods used by CDC’s National Antimicrobial Resistance Monitoring System laboratory on isolates from five ill people and seven puppies in this outbreak. The 12 isolates tested by standard methods were resistant to azithromycin, ciprofloxacin, clindamycin, erythromycin, nalidixic acid, telithromycin, and tetracycline. In addition, 10 were resistant to gentamicin, and 2 were resistant to florfenicol.

In interviews, ill people answered questions about the foods they ate and any animal contact in the week before they became ill. Ninety-nine percent of people reported contact with a puppy in the week before illness started, and 87% reported they had contact with a puppy from Petland stores, or had contact with a person who became sick after contact with a puppy from a Petland store. Twenty-five ill people worked at Petland stores.

During the investigation, officials collected samples from pet store puppies for laboratory testing and identified the outbreak strain of Campylobacter in the samples. WGS showed that the Campylobacter isolates from sick people in this outbreak and isolates from pet store puppies were closely related genetically, providing additional evidence that people got sick from contact with pet store puppies.

Ill people reported contact with different breeds of puppies at different store locations in several states. The investigation did not identify a common breeder where puppies infected with the outbreak strain of Campylobacter originated. Puppies in this outbreak may have become infected at various points along the distribution chain when they had contact with infected puppies from other breeders or distributors during transport to pet store locations. Enhanced infection prevention measures throughout the distribution chain may help reduce the spread of Campylobacter infections among puppies.

This multidrug-resistant outbreak highlights the need for responsible use of antibiotics in pets. Education about best practices for Campylobacter disease prevention, diarrhea management in puppies, and responsible antibiotic use is essential throughout the distribution chain to help prevent the emergence and spread of antibiotic resistance. Pet owners should be aware that any puppy or dog, regardless of where it is purchased or adopted, may carry germs like Campylobacterthat can make people sick. Always wash your hands thoroughly with soap and water right after touching puppies and dogs or after picking up their poop. Work with your veterinarian to keep your animal healthy to prevent disease. More information about how to prevent illness when handling puppies and dogs is available for pet owners.

Does Europe have an egg problem? Salmonella cases no longer falling in the EU

The declining trend of salmonellosis cases in the EU has levelled off according to the annual report on zoonotic diseases published today.

The European Centre for Disease Prevention and Control reports that cases of Salmonella Enteritiis acquired in the EU have increased in humans by 3% since 2014. In laying hens, the prevalence increased from 0.7% to 1.21% over the same period. 

“The increase shown by our surveillance data is worrying and a reminder that we have to stay vigilant,” said Mike Catchpole, ECDC’s Chief Scientist. “Even in a state of high awareness and with national control programmes for S. Enteritidis in place, there is a need for continuing risk management actions at the Member State and EU level,” he added. 

Marta Hugas, EFSA’s Chief Scientist, said: “The decrease of Salmonella has been a success story in the EU food safety system in the last 10 years. Recent S. Enteritidis outbreaks contributed to a change in this trend in humans and poultry. Further investigations by competent authorities in the field of public health and food safety will be crucial to understand the reasons behind the increase.” 

There were 94 530 human cases of salmonellosis reported in the EU in 2016. S. Enteritidis – the most widespread type of Salmonella, accounted for 59% of all salmonellosis cases originating in the EU and is mostly associated with the consumption of eggs, egg products and poultry meat. 

Campylobacter and Listeria

Campylobacter, the most reported food-borne pathogen in humans, was detected in 246 307 people, an increase of 6.1% compared with 2015. Despite the high number of cases, fatalities were low (0.03%). Levels of Campylobacter are high in chicken meat.

Listeria infections, which are generally more severe, led to hospitalisation in 97% of reported cases. In 2016, listeriosis continued to rise, with 2 536 cases (a 9.3% increase) and 247 deaths reported. Most deaths occur in people aged over 64 (fatality rate of 18.9%). People over 84 are particularly at risk (fatality rate of 26.1%). Listeria seldom exceeded legal safety limits in ready-to-eat foods.

Salmonella food-borne outbreaks increasing 

The 4 786 food-borne disease outbreaks reported in 2016 represent a slight increase in comparison with 2015 (4 362 outbreaks), but the figure is similar to the average number of outbreaks in the EU during 2010–2016. 

Outbreaks due to Salmonella are on the rise, with S. Enteritidis causing one in six food-borne disease outbreaks in 2016. Salmonella bacteria were the most common cause of food-borne outbreaks (22.3%), an increase of 11.5% compared to 2015. They caused the highest burden in terms of numbers of hospitalisations (1,766; 45.6% of all hospitalised cases) and of deaths (10; 50% of all deaths among outbreak cases).

Salmonella in eggs caused the highest number of outbreak cases (1 882).

Sounds like Walkerton: More than 750,000 in NZ exposed to potentially unsafe drinking water

Same old, same old.

Tracy Watkins of Stuff writes complacency, inept officials – a Government inquiry paints a frightening picture of the state of New Zealand’s drinking water, with at least 750,000 of New Zealanders drinking from supplies that are “not demonstrably safe” – a figure described as likely to be a “significant underestimate.”

The inquiry was sparked by the 2016 Havelock North gastro outbreak, which has now been linked to four deaths, and calls for a major overhaul of water supplies, including mandatory treatment.

The Government has now written urgently to all mayors and district health boards asking to check the water they are supplying meets current standards after the inquiry revealed 20 per cent of water supplies were not up to standard.

That 20 per cent affects 759,000 people, of which 92,000 are at risk of bacterial infection, 681,000 of protozoal infection and 59,000 at risk from the long term effects of exposure to chemicals through their water supply.

But that figure was likely to understate the problem, as it did not include more than 600,000 people who drink water from self-suppliers or temporary suppliers, or tourists to places like Punakaiki on the West Coast, which is under a permanent “boil water” notice.

The inquiry found that complacency about the state of New Zealand’s drinking water was common, yet the evidence showed that in many cases it was safer to drink tap water overseas than here.

But its most damning findings related to the Ministry of Health, which it described as inept and negligent in its oversight of a system in which non-compliance with safe standards was high.

The risks for contamination of the water supplies were detailed by the inquiry including damaged pipes, a huge number of private and unknown bores, and the close proximity of sewerage to drinking water assets, a factor that caused surprise among overseas experts.

The second part of the inquiry looked at broader water quality issues.

It found that lessons from Havelock North appeared not to have been learned – compliance figures in the 2016-17 period were still “alarmingly low” and “do not appear to reflect any increased vigilance by suppliers in the aftermath of [that] outbreak”.

“The inquiry found the falling compliance levels with the bacteriological and chemical standards particularly concerning. The decrease in compliance with the bacteriological standards results from an increased number of transgressions, an increased number of supplies with ineffective, delayed or unknown remedial action following transgressions, and an increased number of supplies with inadequate monitoring.

“Twenty-seven supplies failed entirely to take any remedial action after a transgression. In the aftermath of the bacteriological outbreak in Havelock North, these failures to respond effectively to transgressions or to monitor adequately are surprising and unacceptable.”

Less food poisoning associated with employee paid sick time?

I refer to parenting as hypocrisy disease.

And there’s been more than a few times when Amy has said to me, practice what you preach.

Like barfing and going to work.

People should not work when they are sick.

But in the world of food, people are going to lose their jobs if they don’t show up.

Hsuan et al. write in the American Journal of Preventative Medicine that:

Previous studies suggest an association between paid sick leave (PSL) and better population health, including fewer infectious and nosocomial gastrointestinal disease outbreaks. Yet few studies examine whether laws requiring employers to offer PSL demonstrate a similar association. This mixed-methods study examined whether laws requiring employers to provide PSL are associated with decreased foodborne illness rates, particularly laws that are more supportive of employees taking leave.

Methods:

The four earliest PSL laws were classified by whether they were more or less supportive of employees taking leave. Jurisdictions with PSL were matched to comparison jurisdictions by population size and density. Using difference-in-differences, monthly foodborne illness rates (2000-2014) in implementation and comparison jurisdictions before and after the laws were effective were compared, stratifying by how supportive the laws were of employees taking leave, and then by disease. The empirical analysis was conducted from 2015-2017.

Results:

Foodborne illness rates declined after implementation of the PSL law in jurisdictions with laws more supportive of employees taking leave, but increased in jurisdictions with laws that are less supportive. In adjusted analyses, PSL laws that were more supportive of employees taking sick leave were associated with an adjusted 22% decrease in foodborne illness rates (p=0.005). These results are driven by campylobacteriosis.

Conclusions:

Although the results suggest an association between more supportive PSL laws and decreased foodborne illness rates, they should be interpreted cautiously because the trend is driven by campylobacteriosis, which has low person-to-person transmission.

Association of paid sick leave laws with foodborne illness rates

Am J Prev Med. 2017 Sep 1. pii: S0749-3797(17)30359-8. doi: 10.1016/j.amepre.2017.06.029. [Epub ahead of print]

Hsuan C, Ryan-Ibarra S, DeBurgh K, Jacobson DM

https://www.ncbi.nlm.nih.gov/pubmed/28870665

Campylobacter uses other organisms to multiply and spread

Campylobacter spp. are extremely sensitive to environmental conditions and do not multiply at temperatures below 30C, however, they can survive temperatures as low as 4C for several months. They remain to be a prevalent pathogen on chicken and identified as a source of many outbreaks associated with unpasteurized milk.

Kingston University researchers have found that Campylobacter jejuni can multiply and spread using another organism’s cells.

Kingston University researchers have shown how a leading cause of bacterial food poisoning can multiply and spread – by using another organism’s cells as a Trojan horse.
Campylobacter jejuni is one of the most common causes of gastroenteritis in the United States and Europe, often infecting humans through raw or undercooked poultry. The new study revealed how the bacteria can infiltrate micro-organisms called amoebae, multiplying within their cells while protected inside its host from harsh environmental conditions.
As well as leading to a better understanding of how bacteria survive, the research could help efforts to prevent the spread of infection, according to lead author and PhD student Ana Vieira.
“Establishing that Campylobacter can multiply inside its amoebic hosts is important, as they often exist in the same environments – such as in drinking water for chickens on poultry farms – which could increase the risk of infection,” she said. “The amoeba may act as a protective host against some disinfection procedures, so the findings could be used to explore new ways of helping prevent the bacteria’s spread by breaking the chain of infection.”
The relationship between Campylobacter and amoebae has been hotly debated in scientific circles – with conflicting findings in previous studies as to whether the bacteria multiply inside, or only in the beneficial environment around, amoebae cells.
The Kingston University team used a modification of a process that assesses the bacteria’s ability to invade cells – called the gentamycin protection assay – to confirm they can survive and multiply while inside the amoeba’s protective environment.
This allows Campylobacter to thrive, escaping the amoeba cells in larger numbers – shining a light on how it spreads and causes disease, professor of microbiology Andrey Karlyshev, a supervisor on the study, explained.
“Our research gives us a better understanding of bacterial survival,” he said. “Because amoebae are widespread, we have shown how Campylobacter bacteria are able to use them as a Trojan horse for infection of the food chain. Otherwise they wouldn’t survive, as they are very sensitive to the environment.”
As part of the study, the researchers showed how a system used by the bacteria to expel toxins – known as a multidrug efflux pump – plays a key role in its ability to thrive within the amoebae.
The team examined how this system helps the bacteria become resistant to antibiotics, which could lead to new methods of preventing resistance from developing, Professor Karlyshev added.
“Campylobacter is becoming increasingly resistant to antibiotics because of their wide use on humans and animals,” he said. “Due to its role in antibiotic resistance and bacterial survival in amoebae, the efflux pump could prove to be a good target for the development of antibacterial drugs.
“Targeting the bacterial factors required for survival within amoebae could help to prevent Campylobacter from spreading in the environment and colonising chickens. This is turn could help reduce its ability to enter the food chain and cause disease in humans.”

 

Use a thermometer: 21 sickened: Campy in UK liver pate, again

Yorkshire Coast Radio reports Diversorium Ltd, the company which owns and operates the Downe Arms, a country inn hotel in Wykeham near Scarborough, has been fined £8,000 for two serious food hygiene related offences after an outbreak of Campylobacter food poisoning was traced back to contaminated chicken liver pate eaten at the hotel.

Following a prosecution by Scarborough Borough Council, Diversorium Ltd pleaded guilty at Scarborough Magistrates Court to two offences under the Food Safety and Hygiene (England) Regulations after 21 people fell ill following a Christmas party night on 17 December 2016 and a Christmas break package at the hotel during the same month. The court ruled that fines of £5,000 and £3000 respectively should be paid for the offences. The company was also ordered to pay the council £2170 in costs.

The council’s Environmental Health team received complaints from those affected by the food poisoning and during the subsequent investigation it was apparent that there were a number of issues which were not consistent with good hygiene practices and food safety management records were incomplete. In particular, the process for preparing the chicken liver pate had not been validated by appropriate temperature monitoring and recording, and food safety was not being managed effectively. The extensive investigation, carried out in conjunction with Public Health England, concluded that the pate was the most probable cause of the illness. The business was subsequently marked down to a food hygiene rating of 1 (major improvement necessary).

Hockey player diagnosed with Guillain-Barre syndrome

For some reason, Chapman doesn’t try hard, but he gets the best soundbites

If there was any band to be the lab house band back in the day, it was the Hip.

Hockey, rock ‘n roll, Canada.

Anaheim Ducks forward Patrick Eaves has been diagnosed with Guillain-Barre syndrome, and his hockey career is on hold while he recovers.

The Ducks announced Eaves’ diagnosis Monday, and the club disclosed that the veteran goal-scorer was in intensive care last week.

Eaves is still hospitalized in Newport Beach, California, but his condition has stabilized.

“I’m on the road to recovery,” Eaves said in a statement issued by the Ducks. “I’ve received tremendous amount of support over the last few days, most importantly from my family, friends and teammates. I’m determined to fully overcome this and return to the ice as soon as possible.”

It was probably foodbore Campylobacter.

Guillain-Barre syndrome is a rare disorder in which a patient’s immune system attacks the nervous system, sometimes resulting in death. Eaves’ condition was diagnosed early, an important factor in successful treatment.

Eaves thanked two specialists — Dr. Robert Watkins Sr. and Dr. Danny Benmoshe — for quickly discovering the disorder last week. Ducks general manager Bob Murray also praised the doctors.

“Our sole focus at this time is on Patrick’s general health and well-being,” Murray said. “What defines Patrick Eaves is his strength of character, and that will serve him well in his recovery.”

The 33-year-old Eaves joined the Ducks from Dallas as a late-season trade rental in late February. He played a key role in their push for a fifth straight Pacific Division title, excelling on the power play and racking up 11 goals in 20 games.

Despite missing the final 10 games of the regular season due to injury, he finished with a career-high 32 goals between the Ducks and Stars. He played seven games in the post-season, but sat out the final 10 games with a sprained right ankle while Anaheim reached the Western Conference finals.

Instead of seeking bigger offers in free agency, he re-signed with the Ducks in June, agreeing to a three-year, $9.45 million deal. He was expected to be a key top-six forward for the Ducks this season.

Eaves also has suited up for Ottawa, Carolina, Detroit and Nashville during his 12-year NHL career.


 

7 sick: Not just a UK problem: Outbreak of Campylobacter jejuni associated with consuming undercooked chicken liver mousse

The U.S. Centers for Disease Control reports that on July 13, 2016, Clark County (Washington) Public Health (CCPH) received a report of diarrheal illness in four of seven members of a single party who dined at a local restaurant on July 6, 2016. The report was received through an online/telephone system for reporting food service–associated illness complaints. Members of the five households in the party reported that their only shared exposure was the restaurant meal. CCPH ordered closure of the restaurant kitchen on July 13, 2016, and began an investigation to identify the source of diarrheal illness and implement additional control measures.

CCPH defined a probable case of restaurant-associated illness as diarrhea lasting >2 days in any restaurant guest or staff member with illness onset from July 1, 2016, to July 23, 2016. After Campylobacter jejuni was cultured from stool specimens submitted by three ill members of the dining party, a confirmed case was defined as culture evidence of C. jejuni infection in any restaurant guest or staff member with onset of diarrheal illness during the same period. Five cases (three confirmed and two probable) were identified, four in restaurant guests and one in a food worker; patient age ranged from 27–46 years; three patients were female.

CCPH conducted a case-control study involving 28 menu items, using 14 non-ill dining companions and restaurant staff members as controls. Consumption of two menu items, chicken liver mousse (odds ratio [OR] = 36.1, 95% confidence interval [CI] = 1.58–828.9), and grilled romaine hearts (OR = 18, 95% CI = 1.19–271.5) were associated with case status. Because of the higher odds ratio of chicken liver mousse and previous Campylobacter outbreaks associated with chicken livers (1,2), the investigation focused on the mousse.

During an inspection on July 15, the sous-chef solely responsible for preparing the chicken liver mousse demonstrated preparation to the CCPH food safety inspector, who observed that the sous-chef used the appearance of the livers alone to determine whether they were fully cooked. Final internal cook temperature of the largest liver measured by the inspector was <130°F (54°C), below the minimum 165°F (74°C) internal temperature deemed necessary by the Food and Drug Administration to eliminate food safety hazards (3). Because raw chicken parts are not required to be free of Campylobacter (4), and the bacteria might be present on the surface of 77% of retail chicken livers (5), CCPH immediately addressed undercooking of the livers.

One patient stool specimen isolate was available for typing by pulsed-field gel electrophoresis (PFGE). The PFGE pattern from this isolate was indistinguishable from those obtained from two chicken liver samples collected in a 2014 campylobacteriosis outbreak in Oregon (1). Chicken livers associated with both the 2014 outbreak and with this outbreak were supplied by the same company. Chicken livers from the lot served at the restaurant on the day of the implicated meal were no longer available; therefore, the U.S. Department of Agriculture could not pursue testing of chicken liver samples.

Among published C. jejuni outbreaks associated with undercooked chicken livers, this outbreak report is the second from the Pacific Northwest (1), and the first in the United States initially reported through an illness complaint system. Because CCPH does not actively investigate Campylobacter cases in persons aged >5 years, and because Campylobacter PFGE is not routinely conducted in Washington, this outbreak would have likely gone undetected if not for the illness complaint system, demonstrating the value of illness complaint investigations to identify outbreaks and mitigate public health risks.